Background Vertebral fractures are major cause of disability and impaired quality of life in elderly people. Low bone mineral density has been reported a major risk factor for vertebral fracture. In patients with rheumatoid arthritis, it have been suggested that an appropriate management of the disease and the quality of bone prevent vertebral fractures. However, there are limited data concerning risk factors for bone mineral density loss in patients with rheumatoid arthritis.
Objectives To evaluate the risk factors for generalized bone mineral density loss in patients with rheumatoid arthritis.
Methods In a longitudinal study, lumbar spine bone mineral density (BMD) was measured at baseline and after average 1.2 years. Data of RA disease activity, treatment agents towards RA and osteoporosis, dietary and physical status were collected. With univariate logistic regression analyses we tested baseline variables for association with BMD loss. Variables showing an association (p<0.10) with BMD loss were entered as possible predictors in a multivariate logistic analysis.
Results: 218 patients were examined at baseline and follow-up time. Patients included in this study were on average 61 years old and the average disease duration were 12 years at baseline. In the univariate regression analysis, age, smoking status, Steinbrokcer’s stage, usage of drugs for osteoporosis and pre-existing of vertebral fracture at baseline were associated (p<0.10) with lumbar BMD loss. Subsequently in multivariate logistic regression analysis, only usage of drugs for osteoporosis was associated with decreased risk for lumbar spine bone mineral density loss (OR 2.57, 95% CI: 1.18-5.66, p= 0.017). In addition, smoking and shortage of calcium intake were associated with BMD loss among current users of drugs for osteoporosis, while among patients without drugs for osteoporosis, low body mass index was associated with BMD loss.
Conclusions Results of this longitudinal study suggest that management of osteoporosis, including drugs and patient education towards life style, is important in patients with rheumatoid arthritis.
Disclosure of Interest None Declared